Esthetic apparatus useful for increasing skin rejuvenation and methods thereof

Abstract

A system is provided for increasing skin rejuvenation of a region of a patient's skin comprising a pulsed electromagnetic field (PEMF) frequency generator for constantly providing electromagnetic pulses to said region of a patient's skin and a deep tissue diathermy device for constantly applying heat to said region of a patient's skin up to temperature T. The system is adapted for simultaneously applying heat and PEMF to the region of a patient's skin. Application of the system increases skin rejuvenation such that the skin rejuvenation increase (SRI) is greater than the sum of the SRI provided by electromagnetic pulses increase and the SRI provided by the deep tissue diathermy device increase.

What is claimed is: 
     
         1 . An apparatus of fractional coring for directional skin tightening, comprising:
 (i) an excisor configured to produce a plurality of excised tissue portions in a region of skin tissue; and,   (ii) a securing fastener configured to secure, to the region of the skin tissue, a tensioner having at least two portions, the tensioner adapted to provide contraction or expansion of said region in at least one predetermined direction; thereby promoting collagen growth and providing directional skin tightening in said skin tissue;   wherein said excisor is configured to be in communication with at least one RF generator, adapted to provide RF energy, such that said excisor is adapted to provide RF energy to said region of skin tissue.   
     
     
         2 . The system of  claim 1 , additionally comprising at least one RF electrode to be placed on a region of skin and deliver RF energy to said region of skin. 
     
     
         3 . The system of  claim 1 , wherein said excisor is in communication with at least one pulsed electromagnetic field frequency generator configured to provide time-varying magnetic pulses. 
     
     
         4 . The system of  claim 3 , wherein said a pulsed electromagnetic frequency generator is in communication with at least one coil. 
     
     
         5 . The system of  claim 4 , wherein the at least one RF electrode is surrounded by at least one coil. 
     
     
         6 . The system of  claim 4 , wherein said at least one electrode is adapted to heat the tissue;
 further wherein said heat application is provided either before, after or simultaneously with the application of said pulsed electromagnetic field.   
     
     
         7 . The system of  claim 3 , wherein at least one of the following is being held true (a) a shape of the pulses is selected from a group consisting of a square wave, a sine wave, a triangular wave, a sawtooth wave, a ramp wave, and a spiked wave and any combination thereof; (b) a duration of each pulse ranges between about 3 and about 1000 milliseconds; (c) a frequency of said pulses ranges between about 1 Hz and about 1M Hz; (d) the power of said at least one RF electrode ranges between about 1 and about 150 watts per pulse; (e) the intensity of each of said time-varying magnetic pulses is in a range of 0 to 3 Tesla; (f) the intensity of each of said time-varying magnetic pulses is in a range of 0 to 40 Gauss; (g) the frequency applied by said RF electrode ranges between about 1 Hz and about 1M Hz; any combination thereof. 
     
     
         8 . The apparatus of  claim 1 , wherein said tensioner comprises at least one selected from a group consisting of (a) at least one occlusion layer adapted to control humidity and/or promote wound healing of said skin; (b) at least one absorption layer adapted to absorb wound exudate; and any combination thereof. 
     
     
         9 . The apparatus of  claim 1 , wherein said excisor is configured to apply said RF energy to the skin tissue to alter one or more properties thereof. 
     
     
         10 . The apparatus of  claim 1 , wherein said producing a plurality of excised tissue portions in a region of skin tissue is performed by a system comprising at least one robotic arm, said at least one robotic arm comprising at least one skin coring instrument. 
     
     
         11 . The apparatus of  claim 10 , wherein said at least one skin coring instrument comprising at least one selected from a group consisting of at least one needle, at least one punch and any combination thereof; said at least one skin coring instrument is configured to contact a surface of the skin to generate holes in the skin tissue by excising portions of the skin tissue. 
     
     
         12 . The apparatus of  claim 10 , wherein said at least one said at least one skin coring instrument is at least 6 punches. 
     
     
         13 . The apparatus of  claim 10 , wherein at least a portion of said at least one punch is disposable. 
     
     
         14 . The apparatus of  claim 10 , wherein at least two of said at least one skin coring instrument are characterized by either a similar or substantially different cross section area. 
     
     
         15 . The apparatus of  claim 10 , wherein at least one of the following is being held true (a) said at least one skin coring instrument is adapted to penetrate said skin to a depth of 1 to 4 mm; (b) said at least one skin coring instrument is characterized by a radius of 0.15 mm-2.0 mm; (c) the cross section area of said at least one skin coring instrument is selected from a group consisting of circular, rectangular, triangular, hexagonal, oval, staggered rows, parallel rows, a spiral pattern, a square or rectangular pattern, a radial distribution and any combination thereof. 
     
     
         16 . The apparatus of  claim 10 , wherein said system additionally comprising at least one controller adapted to control the positioning of said at least one robotic arm relatively to said skin area. 
     
     
         17 . The apparatus of  claim 17 , wherein said controller comprises at least one engine adapted to control at least one parameter selected from a group consisting of the rotation, translation, angle of penetration of said at least one robotic arm relatively to said skin, depth of penetration, coverage rate, the diameter of at least one excised tissue multiplied by number of cores, different area of said skin to be treated and any combination thereof. 
     
     
         18 . The apparatus of  claim 18 , wherein said parameters are adjusted manually by the operator or automatically by said controller. 
     
     
         19 . The apparatus of  claim 18 , wherein said parameters are real time adjusted. 
     
     
         20 . The apparatus of  claim 18 , wherein at least one of the following is being held true (a) said rotation is at a speed in the range of 1000-7000 RPM; (b) said translation is at a speed in the range of 0-500 mm/sec; and any combination thereof. 
     
     
         21 . The apparatus of  claim 10 , wherein said at least one skin coring instrument comprises a plurality of skin coring instruments each of which is configured to rotate individually in a predefined direction in a predetermined speed. 
     
     
         22 . The apparatus of  claim 10 , wherein said at least one skin coring instrument comprises at least two skin coring instruments which are configured to rotate simultaneously. 
     
     
         23 . The apparatus of  claim 10 , wherein each of said at least one skin coring instrument translates individually. 
     
     
         24 . The apparatus of  claim 10 , wherein at least two of said at least one skin coring instrument translate simultaneously. 
     
     
         25 . The apparatus of  claim 10 , wherein said controller comprising a stopper adapted to limit the depth to which at least a portion of said at least one skin coring instrument penetrates said skin. 
     
     
         26 . The apparatus of  claim 25 , wherein said angle of penetration is substantially perpendicular to said skin. 
     
     
         27 . The apparatus of  claim 25 , wherein said controller is adapted to define at least one no-fly zone; said no-fly zone is defined as an area to which said system provides no treatment. 
     
     
         28 . The apparatus of  claim 10 , wherein said skin coring instrument comprises:
 a micro-coring punch including at least six micro-coring needles arranged in a predetermined pattern;   a mechanism configured to rotate each of the micro-coring needles around at least one axis of symmetry of each needle and wherein rotation of each of the micro-coring needles synchronized with the rotation of the rest of the micro-coring needles;   a conveyor configured to advance the micro-coring punch towards skin and to position the micro-coring punch to penetrate the skin to a depth of at least two millimeters; and   a stepper configured to step a micro-coring punch and locate the micro-coring punch such that at least one element selected from a group consisting of vertex, facet and any combination thereof of a stepped micro-coring punch hexagon is overlapped with at least one element selected from a group consisting of vertex, facet and any combination thereof of a previous micro-coring punch hexagon.   
     
     
         29 . The apparatus of  claim 28 , wherein the micro-coring punch is attached to a computer-controlled robotic arm capable of moving in six or more axes corresponding to six degrees of freedom. 
     
     
         30 . The apparatus of  claim 28 , further comprising a video camera configured to provide visual feedback of at least the micro-coring punch and the skin and a closed-loop force sensor to determine when the punches break the skin. 
     
     
         31 . The apparatus of  claim 10 , wherein said apparatus is configured to deliver one or more additives to the skin. 
     
     
         32 . The apparatus of  claim 31 , wherein said additives are selected from a group consisting of therapeutic agents, saline solution growth factors, platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-β), fibroblast growth factor (FGF), epidermal growth factor (EGF), and keratinocyte growth factor); one or more stem cells; steroids, agents which prevent post-inflammatory skin hyperpigmentation, hydroquinone, azelaic acid, kojic acid, mandelic acid, or niacinamide; one or more analgesics; one or more antifungals; one or more anti-inflammatory agents, or a mineralocorticoid agent, an immune selective anti-inflammatory derivative; one or more antimicrobials; a foam; or a hydrogel, one or more antiseptics, one or more antiproliferative agents, one or more emollients; one or more hemostatic agents, a procoagulant, an anti-fibrinolytic agent, one or more procoagulative, one or more anticoagulative agents, one or more immune modulators, including corticosteroids and non-steroidal immune modulators, one or more proteins; or one or more vitamins and any combination thereof. 
     
     
         33 . The apparatus of  claim 10 , wherein said system additionally comprising at least one imaging subsystem adapted to guide said at least one skin coring instrument. 
     
     
         34 . The apparatus of  claim 33 , wherein said imaging subsystem comprises at least one selected from a group consisting at least one camera, under skin imaging, ultrasound-based imaging, OCT and any combination thereof. 
     
     
         35 . The apparatus of  claim 10 , wherein said system additionally comprises at least one vacuum subsystem adapted to apply suction to remove excising portions of said skin tissue. 
     
     
         36 . The apparatus of  claim 35 , wherein said skin is part of a treatment area selected from a group consisting of forehead, cheeks, jaw line, nose, forehead neck, upper arms, abdomen, face, eyelid, chin, forehead, lips, nose, neck, buttocks chest, legs, back and any combination thereof. 
     
     
         37 . The apparatus of  claim 10 , wherein said apparatus is configured to allow focal elimination of redundant dermal tissue for skin tightening, at least partially scar removal, skin rejuvenation, at least partially removal of pigment, at least partially tattoo removal, veins, acne, allodynia, blemishes, ectopic dermatitis, hyperpigmentation, hyperplasia, lentigo or keratosis, loss of translucency, loss of elasticity, melasma, photodamage, psoriasis, rhytides, wrinkles, sallow color, scar contracture, scarring, wrinkles, folds, acne scars, dyschromia, striae, surgical scars, cellulite, tattoos removal, cheek wrinkles, facial wrinkles, facial folds, skin aging, skin contraction, skin irritation/sensitivity, skin laxity, striae, vascular lesions, angioma, erythema, hemangioma, papule, port wine stain, rosacea, reticular vein, or telangiectasia, or any other unwanted skin irregularities and any combination thereof. 
     
     
         38 . The apparatus of  claim 37 , wherein said apparatus is configured to carry out at least partially scar removal said producing a plurality of fractionally excised tissue portions results in replacing one type of collagen by a different type to be synthesized post said removal of said excised tissue portions. 
     
     
         39 . The apparatus of  claim 10 , wherein said apparatus utilizes at least one selected from a group consisting of mechanical visualization, OCT, Ultrasound, machine learning algorithms, artificial intelligence, image processing and any combination thereof to efficiency select the preferred location of the tissue to be treated to enhance outcome of said treatment. 
     
     
         40 . The apparatus of  claim 10 , wherein an areal fraction of excised tissue portions is in the range of about 5% to about 30% of the skin region. 
     
     
         41 . The apparatus of  claims 10 , additionally comprising at least one cutter adapted to grind said excised tissue so as to facilitate extraction thereof. 
     
     
         42 . The apparatus of  claims 1 , additionally comprising at least one temperature sensor. 
     
     
         43 . The method of  claims 42 , additionally comprising a cooler, adapted to regulate the temperature of the skin. 
     
     
         44 . The apparatus of  claim 10 , wherein the distal end of said at least one skin coring instrument additionally comprises at least one selected from a group consisting of at least one impedance, at least one temperature sensor and any combination thereof. 
     
     
         45 . The apparatus of  claim 44 , wherein said at least one selected from a group consisting of at least one impedance sensor, at least one temperature sensor and any combination thereof is adapted to provide an indication as to the depth of penetration of each of said at least one skin coring instrument. 
     
     
         46 . The apparatus of  claim 10 , wherein said at least one skin coring instrument additionally comprising at least one needle, adapted to inject at least one treatment substance to the treatment area. 
     
     
         47 . The apparatus of  claim 46 , wherein said at least one treatment substance is selected from a group consisting of hyaluronic acid, botulinum toxin, collagen, stem cells and any combination thereof. 
     
     
         48 . The apparatus of  claim 10 , wherein said system additionally comprises at least one retainer, in communication with at least one excisor configured to a plurality of excised tissue portions, adapted to contain said excised tissue, without necessitating use of a vacuum. 
     
     
         49 . An apparatus of fractional coring for directional skin tightening, comprising:
 (i) means for producing a plurality of excised tissue portions in a region of skin tissue; and   (ii) means for securing to the skin region a stretching/compression device, having at least two portions, adapted to provide contraction or expansion of said skin region in at least one predetermined direction; thereby promoting collagen growth and providing directional skin tightening in said skin tissue;   wherein said means for producing a plurality of excised tissue portions in a region of skin tissue is in communication with at least one RF generator adapted to provide RF energy, such that said means for producing a plurality of excised tissue portions in a region of skin tissue is adapted to provide RF energy to said region of skin tissue.   
     
     
         50 . The apparatus of  claim 49 , wherein said means of producing a plurality of excised tissue portions in a region of skin tissue is performed by means selected from a group consisting of mechanical means, application of temperature to heat and evacuate tissue, application of laser, pulsed electromagnetic field, RF, coblation, coagulation, microwave energy, ultrasound, application of any other type of energy and any combination thereof.